What next for ACA? A great look back from JHPPL

Irrelevant but nice picture

As of today, no one quite knows what will happen to ACA. Republicans control the required levers to massively repeal or replace ACA. They also have the power to massively over-reach and do themselves profound political damage through over-reach that damages millions of peopleâ€™s lives or that damages the overall health care delivery system. Trumpâ€™s unexpected victory provides a remarkable natural experiment that illuminates bedrock issues: The power and accuracy of media messages in public policy, path dependence as a barrier to radical policy change, tensions between interest-group and partisan politics, fiscal federalism and the relationship between states and the federal government, the politics of race and class in redistributive programs. Itâ€™s all there in the politics of health reform.

Post-November 8 is a great time to explore these questions and to look back on what some of the best health policy scholars, political scientists, and sociologists have had to say about the enactment, implementation, and political reception facing health reform. The Journal of Health Politics, Policy, and Law has therefore opened some of its best pieces on ACA for public access. I recommend this to anyone serious about understanding the rise and potential fall of the Affordable Care Act, on which rides the health and well-being of many millions of people. (FYI: I am JHPPL’s social media editor.)

We are watching history in action. It isnâ€™t pretty to watch. We can at least witness the process with analytic rigor informed by a sound understandingÂ of what has come before.

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect, tnr.com, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.
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One thought on “What next for ACA? A great look back from JHPPL”

Obama and the Democrats shrewdly (for once) launched a flawed system with the understanding that it could be improved or modified later, but the only way to replace it entirely would be essentially by expanding Medicare/Medicaid to cover the same people. I think the Republicans are very limited in how much damage they can do, if any. Trump will need all his PR skills to persuade his supporters that he accomplished anything, but I suspect he will find a way. After all, he just sold a bailout of Carrier as a populist victory.